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Saturday, August 11, 2012

The Manager's Gold Standard of Care

You are a manager.  I'm betting that you have a way of articulating to your team members what your expectations are with regard to the standard of care you expect for the patients you serve.  If not, maybe you need to go back and visit a prior blog on "Have High Expectations".  I believe that I have been consistent over the years and said that I expect we will provide care as if we were caring for our own family members.  That's not been a bad Gold standard for me, because my family members and myself have been the recipient of care at the hands of my employees.  It's those times when you are glad that you don't have to worry about who might be working on that shift.  If you manage each day so that your team is always ready to care for a member of your family it is really hard to go wrong.

Next Tuesday, I'm having surgery.  I'm one of those consumers who knows too much.  I know about how hard it is to get 100% of any group of professionals to wash their hands between patients, I know about medication errors, I know about the push to turn over surgery rooms as fast as possible because time is money.  I won't drone on.  What I hope for the manager's that oversee the staff that will be attending to me is that they are serious about the recruitment and selection process.  I hope they come out of their offices and visit with their employees and know who is not acting right, who may be overly stressed and may need a break.  I hope they have been brave enough to deal with the employees who have had persistent attitude problems.  I hope that they are on top of each employees competencies.  Yes, I really hope that they are assured that everyone on their team can take care of me as well as if I were a member of their family.

Can we depend upon outside agencies?  Just about every hospital is Joint Commission accredited.  What does that accreditation mean?  The survey is a weeklong exhibition of everything we do to meet their standards.  I'm sure things would be not very good without those standards in place.  But that exercise reminds me of Horst Shultze comment about being the best of a group of poor performers.  The fact is that bad things still happen in Joint Commission accredited hospitals.  For Nursing, Magnet verification by the American Nurse Credentialing Center verifies that the hospital meets standards for the work environment for nurses.  Magnet hospitals are the best places for nurses to work.  Nurses find an environment of shared governance, support for research, an engaged leadership, and multidisciplinary committee work.

Quality Awards, regulatory agencies and inspect and organizations can meet their minimum standards at a point in time.  But a culture of meeting a Gold Standard on a daily basis is something an organization has to live.  It is not something that passes with an inspection or a survey.  It takes inspiring leadership to create a culture of "this is the way we do our work."  I have tried to not say, we are doing this or that because of the joint commission.  The better leadership statement is "We are doing this for our patients".  The fact that it is a Joint Commission standard is secondary.  Every joint commission standard is related to a risk for a patient.  Another good point to remember is when an employee is objecting to doing something new the leader can simply ask "What is bad about this for our patients?"

This week I got to meet with some of our Patient Transporters.  They get it!  They know that in their 24 minutes of transporting a patient to or from a diagnostic test, they have an opportunity to visit with the patient and lift a spirit.  They know that it's not about them, it's about their patient.  This is who I want to care for my family members!

I rounded on some of our environmental services staff yesterday.  They proudly showed me the rooms they had just cleaned for the next patient.  They knew their role in good hand hygiene.  They enjoy interacting with the patients and just checking to see if the patient needs them to do anything to their room.  This is who I want caring for my family member!

Last week I met with a whole room full of dietitians.  You wouldn't believe the complexity of their role.   The premature neonates have to have banked breast milk managed.  I attended a meeting and watched as the geriatrician, the pharmacist, and the nutritionist agreed on the medications and nutrition for the geriatric patients.  This is the team I want caring for my family members!

If you set the Gold Standard of Care, your personnel's performance becomes much more clear.  Either you would be OK or not OK with them caring for your family member.  If not OK, better start coaching.

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